Help me potty train my 4 1/2 year old!

[momSR]

What should I do now?  My daughter will be 5 years old this summer.  She is still pooping in her underpants regularly.  I have tried everything from rewards, ignoring it, potty time routine, to putting her in complete charge of the potty.  I thought it was diet related.  We tried Activa yogurt and it worked for a while.  Now she is back to pooping in her pants 5 times a day.  I think she holds it in until she can't hold it anymore and then it starts to come out.  She says that she doesn't know when she has to go.  She is willing to eat prunes and drink prune juice.  She says that she wants to go to the potty.  I feel so badly b/c she said to me the other day "am I sick, I must be sick, why else would I still be pooping in my pants?"  That broke my heart.  She is starting full-day kindergarten in september and so I am really feeling the pressure of a deadline.  She is embarrassed when she poops in her pants if her friends are over.  I feel like she is getting too emotional about this and now she has a complex.  There were times I was getting very frustrated about it, now I try to stay calm and relaxed.  I reassure her that I am not disappointed.  I don't know if I should be trying to increase her fiber, or will that just make her poop more often in her pants?  Her poop schedule runs our life.  If she is able to get a big poop in the potty, we can be relaxed and know that she will be clean for the rest of the day.  Should I take her to see a gastroenterologist?  I also tried mineral oil once, and then she had total uncontrolled diarrhea for 3 days.  What should I do?  Please HELP...          

[Kevin Kennedy, Ph.D.]

Yes, you should enlist the help of her pediatrician. It will likely not be necessary to have her see a specialist - this is not an uncommon condition for pediatricians to handle. You should not be attempting to handle this by use of laxatives, mineral oil, etc - let her doctor guide you about this.